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Individual

MARY ELIZABETH LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP-BC, MSN

Contact information

Practice address
1350A CLEVELAND ST, GREENVILLE, SC 29607-2408
(864) 455-1600
Mailing address
1181 FIRST COLONIAL RD, STE 200, VIRGINIA BEACH, VA 23454-2437
(757) 425-1600

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
0024173336
VA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
19119
SC

Other

Enumeration date
10/24/2014
Last updated
08/19/2019
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